Friday, December 26, 2014

Prognosis for Cliff Lee's return

Last night, the Phillies announced pitcher Cliff Lee was heading to the disabled list with the dreaded "elbow strain."

Prognosis for Cliff Lee's return

Phillies starting pitcher Cliff Lee. (Ron Cortes/Staff Photographer)
Phillies starting pitcher Cliff Lee. (Ron Cortes/Staff Photographer)

The Phillies announced pitcher Cliff Lee was heading to the 15-day disabled list due to what have become the two most feared words in Major League Baseball—“elbow strain.”

Recently, a long list of pitchers have headed to the disabled list with similar ailments, only to be diagnosed with the dreaded ulnar collateral ligament (UCL) tear, the condition that leads to Tommy John Surgery.

Fortunately, that’s not the case for Lee, who went as far as to specify that his injury was “not a Tommy John thing.” What Lee has is a grade 1/2 left elbow strain, a condition that will likely have him out a little longer than the 15 days he’s required to sit.

“A Grade 1 or 2 strain indicates a muscular issue—not a ligament,” says Brian Cammarota, M.Ed, A.T.C., C.S.C.S., C.E.S. of Symetrix Sports Performance and OAA Orthopedics.  “On the inside of the elbow you have four muscles—he likely strained those muscles, which is fairly common.”

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So it’s a sigh of relief for Phillies fans, right? “Every situation is a little bit different, so there are no guarantees,” cautions Cammarota. “But when you hear elbow strain… if I had to choose, this is the injury you would want him to have.”

That said, any injury to a pitcher has to be taken seriously. “Shoulder, elbow—any time you’re feeling pain in these areas, your body is telling you something,” says Cammarota. “It could be as simple as fatigue. I know he’s thrown a few starts since the problem started, so that tells me they’ve been trying to manage it, but things haven’t improved.”

Indeed, Lee initially felt discomfort more than a month ago while pitching against the Atlanta Braves. He has continued to pitch with the aid of anti-inflammatories since that time, but now will take a full week off from any type of throwing before starting the process that the Phillies hope will see him back on the mound by mid-June.

“For a Grade 1 strain, a week off is the first cut-off to use,” adds Cammarota. “After five, six days you re-evaluate and if there’s no pain, you can begin a throwing program and try to progress from there.”

“But if he’s taking a week off from throwing, I would think it will be at least three weeks until he returns to game action.”

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Brian Cammarota, MEd, ATC, CSCS, CES Partner at Symetrix Sports Performance
Ellen Casey, MD Physician with Drexel University Sports Medicine
Desirea D. Caucci, PT, DPT, OCS Co-owner of Conshohocken Physical Therapy, Board Certified Orthopedic Clinical Specialist
Michael G. Ciccotti, M.D. Head Team Physician for Phillies & St. Joe's; Rothman Institute
Julie Coté, PT, MPT, OCS, COMT Magee Rehabilitation Hospital
Peter F. DeLuca, M.D. Head Team Physician for Eagles, Head Orthopedic Surgeon for Flyers; Rothman Institute
Joel H. Fish, Ph.D. Director of The Center For Sport Psychology; Sports Psychology Consultant for 76ers & Flyers
R. Robert Franks, D.O. Team Physician for USA Wrestling, Consultant for Phillies; Rothman Institute
Ashley B. Greenblatt, ACE-CPT Certified Personal Trainer, The Sporting Club at The Bellevue
Eugene Hong, MD, CAQSM, FAAFP Team Physician for Drexel, Philadelphia Univ., Saint Joe’s, & U.S. National Women’s Lacrosse
Martin J. Kelley, PT, DPT, OCS Advanced Clinician at Penn Therapy and Fitness, Good Shepherd Penn Partners
Julia Mayberry, M.D. Attending Hand & Upper Extremity Surgeon, Main Line Hand Surgery P.C.
Jim McCrossin, ATC Strength and Conditioning Coach, Flyers and Phantoms
Kevin Miller Fitness Coach, Philadelphia Union
Heather Moore, PT, DPT, CKTP Owner of Total Performance Physical Therapy, North Wales and Hatfield, PA
Kelly O'Shea Senior Health Producer,
Tracey Romero Sports Medicine Editor,
David Rubenstein, M.D. Team Orthopedist for 76ers; Main Line Health Lankenau Medical Center
Robert Senior Event coverage, Sports Doc contributor
Justin Shaginaw, MPT, ATC Athletic Trainer for US Soccer Federation; Aria 3B Orthopaedic Institute
Thomas Trojian MD, CAQSM, FACSM Associate Chief of the Division of Sports Medicine at Drexel University
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